Digitalising healthcare

Advances in digital innovation are helping transform health and social care in Northern Ireland, and according to Director of Digital Health and Care Northern Ireland (DHCNI) AND Deputy CDIO at the Department of Health, Tom Simpson, the benefits are not confined to clinical outcomes and greater efficiencies.

The Department’s flagship encompass programme is being rolled out across the region and Simpson believes the advantages it offers for patients is front and centre in terms of measuring its success.

He says: “Digital transformation is about much, much more than technology, it is about people, it is about processes. In terms of healthcare, fundamentally, it is about patients and how we deliver their care, and how we make services safer, more efficient, and more accessible for patients and staff.”

While Northern Ireland has a fully integrated health and social care system, Simpson points out that the sector provides for a broad base of activities in a complex interdependent environment. Explaining the thinking behind encompass, Simpson says its key function is to support the transformation of the delivery of services for a population of nearly two million and a health and care staff of around 80,000.

“The landscape provides some very specific challenges that have also been an impetus for change. This includes a vast number of digital systems that do not integrate or do not allow data to flow how we would like. Many of these are on a burning platform as they near end of life and a need then to have a sustainable future proof solution that does not risk availability and reliability problems.

“A major issue faced is in the duplication of work that has happened and the risk of missed communication. Clearly that is something that has massive consequences in terms of risk of patient safety but also in terms of efficiency in a system that is resource and finance constrained. Patients routinely did not have access to their own data so that is a missed opportunity in terms of engagement, helping them to engage better with their care which can lead to improved outcomes. In this case, transformation through improved digital care is crucial.

“We are deploying a lifelong electronic care record. We have partnered with Epic platform which has three million users worldwide. It provides us with a comprehensive platform that allows us to provide standardised care across the region irrespective of geography.” One of the key benefits of encompass, he says, is in terms of helping clinicians and thus improving clinical outcomes for patients as well as well as resulting in greater efficiencies and savings across the system.

“Primary care is not fully integrated, but GPs do have access to the system and have some limited functionality for referrals and orders. So through this platform we can improve clinical outcomes supported by accurate timely coordinated care; we can introduce patient access to data and, over the lifetime of the programme, we will see around £30 million worth of cashable benefits and a further half billion of non-cash releasing benefits.”

“The reality is that data in the health and social care system in Northern Ireland has, up until now, been fragmented, siloed, and difficult to use effectively and encompass provides us with a single comprehensive record which could create a real time connected and standardised source of truth across the whole system.

“We are moving from a system in which decisions were being made using incomplete information to one where clinicians, managers, and policymakers have the right information at the right time, enabling better clinical decisions, allowing proactive and preventative care, and reducing duplication and inefficiency.”

A key element in the encompass programme is the patient portal to the system Mycare. This, Simpson explains, “enables patients to be active participants in their care, they can view their records, they can get test results, they can communicate with clinicians”.

Not only does this create efficiencies across the system, it gives patients greater ownership of their own health, he says.

“It is not just about conveniences, this is about empowerment. When people have access to their own data they have better understanding of their health, they can track their progress, and they can make informed decisions,” he adds.

“The encompass programme is now adopted and in use across all five provider trusts in Northern Ireland, delivering a single digital care record for every citizen who receives health and social care in hospitals or trust settings. This marks a major milestone: for the first time, all of the Northern Irish provider trusts are now using the same digital health and care record system.

“I cannot emphasise enough how reliant this programme is on people. We have invested heavily in dedicated staff, but probably more important than that is the training that has gone across the whole system.

“The greatest gain in optimisation comes from investing in the people who are actually using the platform, ensuring they get the best from it. And we have got people working across every trust, every profession, and every level of the health system ensuring that this is not just an IT deployment, but a true shift in how we provide care in Northern Ireland.

“As we move past implementation and into optimisation and transformation, the focus is now on embedding these changes into the fabric of our health care system, ensuring that the transformative benefits of encompass are realised, sustained, and built upon for years to come.”